High levels of homocysteine in human plasma are correlated with increased risks for coronary heart disease, stroke, arteriosclerosis, and other diseases. As a result, it is desirable to screen the general population for elevated amounts of this amino acid. To make wide-scale testing for homocysteine feasible, new and less expensive assays need to be developed.
Plasma homocysteine is routinely measured by high-pressure liquid chromatography (HPLC) and gas chromatography/mass spectrometry (GC/MS) at a cost of over $100 per assay, making these physical separation methods too costly for a population-wide study. For example, urine or blood samples can be prepared for amino acid chromatography, and L-homocysteine measured by HPLC separation and detection. Fiskerstrand et al. (Clin. Chem., 39:263-271 (1993)) describe a method of assaying L-homocysteine using fluorescent labeling of serum thiols, followed by HPLC separation and detection of the L-homocysteine derivative from the various other sulfur-containing compounds. However, such methods are typically time consuming, costly, and not readily available to many laboratories.
Indirect immunoassays for homocysteine have also been developed, however, these antibody methods are still relatively expensive at about $24 per test. One particular indirect immunoassay enzymatically converts homocysteine to adenosyl homocysteine and the amount of adenosyl homocysteine is determined by a competitive ELISA (enzyme linked immunoassay), using an anti-adenosyl homocysteine antibody (for example, see U.S. Pat. No. 5,827,645, the content of which is incorporated herein by reference).
Indirect enzyme assays have been developed for the quantitation of L-homocysteine. For example, the enzyme S-adenosyl-homocysteine hydrolase and adenosine are added to a test sample. The resulting concentration, or change in the concentration, of adenosine in the reaction mixture is used as an indicator for the initial concentration of homocysteine in the sample.
Direct enzyme assays have also been reported for measuring homocysteine. Typically, these protocols irreversibly convert homocysteine to other compounds that are quantifiable. For example, the enzyme homocysteine dehydratase has been used to remove the sulfhydryl group from homocysteine. The concentration of the removed sulfflydryl moiety is then measured. A major drawback with this and other enzyme assays for homocysteine is that the enzymes employed react with other sulfur containing amino acids and compounds related to homocysteine, leading to a high and inconsistent background and measurements of homocysteine from plasma that are inaccurate.
Enzymatic (or enzymic) cycling assays have been reported for a very small number of analytes. In an enzymatic cycling assay two or more enzymes activities are used which recycle substrate and do not irreversibly convert the measured compound. Instead the xe2x80x9ccompoundxe2x80x9d is used catalytically to control the rate of conversion to the quantitated compound in the assay. As a result, the analyte of interest remains in a steady-state concentration which is low enough to create a pseudo-first order rate of reaction. The steady-state concentration of the analyte is thereby linearly related to the rate of the overall assay. By measuring reaction rates, the amount of the analyte is easily determined. Enzymatic cycling assays are sometime called xe2x80x9camplificationxe2x80x9d assays, because the methods typically increase the sensitivity of measurement for an analyte by 100- to 1000-fold. The amplification in measurement is a direct result of not reducing the steady-state concentration of the compound. No enzymatic cycling assay has been reported for measuring homocysteine.
The present invention provides an enzymatic cycling assay for homocysteine and/or cystathionine which is less expensive, and provides a higher sample throughput than the diagnostic assays currently available. Further, the invention provides methods and vectors for the recombinant production of enzymes which can be used in the production of assay reagents and test kits for assessing the amount of homocysteine and cystathionine in a sample.
The present invention provides an enzymatic cycling assay method for assessing the amount of homocysteine and/or cystathionine in a solution. The assay takes advantage of the reaction of homocysteine and L-serine to form cystathionine by the enzyme cystathionine xcex2-synthase (CBS), or a derivative thereof, and the enzymatic conversion by cystathionine xcex2-lyase (CBL) of cystathionine to homocysteine, pyruvate and ammonia. The assay provides a steady-state concentration of the homocysteine and/or cystathionine which is linearly related to the rate of the overall reaction. The amount of homocysteine and/or cystathionine determined in a sample is based on the amount of pyruvate and/or ammonia which is formed or the amount of serine removed from the reaction mixture. Solutions which can be tested using the assay of the present invention can include laboratory samples of blood, serum, plasma, urine, and other biological samples. Additionally, any other liquid sample can be tested.
In one embodiment, the present invention provides a method for assessing the amount of homocysteine and/or cystathionine in a solution comprising the step of:
(a) contacting the solution containing homocysteine and/or cystathionine (either before and/or after performing a disulfide reduction step) to form a reaction mixture, with CBS, or a derivative thereof, L-serine and CBL, or a derivative thereof, for a time period sufficient to catalyze the cyclical conversion of homocysteine to cystathionine, and the reconversion of cystathionine to homocysteine with the production of pyruvate and ammonia;
(b) determining the amount of pyruvate and/or ammonia present in the reaction mixture; and
(c) assessing the amount of homocysteine and/or cystathionine present in the solution based on the amount of pyruvate and/or ammonia formed.
More particularly, the method provides for the assessment of the amount of homocysteine by the addition of the inexpensive amino acid L-serine. The amount of pyruvate present in the reaction mixture can be measured in a number of ways. In one particular embodiment of the present invention lactate dehydrogenase (LDH), or a derivative thereof, and NADH (reduced nicotinamide cofactor), or a derivative thereof, are present in the reaction mixture. LDH in the presence of NADH converts pyruvate to lactate with the oxidation of NADH to NAD+ (oxidized nicotinamide cofactor).
The oxidation of NADH to NAD+ can be measured by a number of methods known in the art including monitoring the reaction mixture at 340 nm. Production of NAD+ can also be monitored by the oxidation of a dye to produce an observable color change. Dyes preferred for use in the present invention include, but are not limited to, 5,5xe2x80x2-dithiobis(2-nitrobenzoic acid), 2,6-dichlorophenylindophenol, tetrazolium compounds, phenazine methosulfate, methyl viologen, or derivatives of any of these dyes. The amount of homocysteine and/or cystathionine present in the solution is based on the intensity of the observed color compared to a standard curve constructed for samples of known concentration of the analyte.
In an alternative embodiment pyruvate oxidase, with horseradish peroxidase, in the presence of hydrogen peroxide and a chromogen are used to detect the amount of pyruvate present in the sample. Sodium N-ethyl-N-2-hydroxy 3-sulfopropyl) m-toluidine (TOOS) and other N-ethyl-N-(2-hydroxy-3-sulfopropyl)-aniline derivatives are preferred chromogens for this colorimetric reaction. As above, the amount of homocysteine and/or cystathionine present in the sample is based on the intensity of the observed color compared to a standard curve constructed for samples of known concentrations of the analyte.
The amount of homocysteine and/or cystathionine present in a solution can also be measured based on the amount of ammonia present in the reaction mixture. Methods for determining the concentration of ammonia in a solution are legion. In one particular embodiment of the present invention, the amount of ammonia is measured using a commonly available standard ammonia sensor.
In another embodiment, the present invention is directed to a method for assessing the amount of homocysteine and/or cystathionine in a sample comprising the steps of contacting the solution with a reducing agent for a time period sufficient to reduce substantially all homocysteine and other disulfides that are present in the solution to homocysteine. Treatment with a reducing agent can also act to release homocysteine which is attached to a protein and/or other molecules present in a solution through a disulfide bond. After reduction the solution is then contacted with CBS, or a derivative thereof, L-serine, and CBL, or a derivative thereof, for a time period sufficient to catalyze the cyclical conversion of homocysteine to cystathionine and the conversion of cystathionine to homocysteine with the production of pyruvate and ammonia. To assess the amount of homocysteine and/or cystathionine present in the solution the amount of pyruvate and/or ammonia present in the reaction mixture can be determined as set forth above. Preferred reducing agents for use in the present invention include borohydride salts and thiol reducing agents. Typical thiol reducing agents appropriate for use in the present embodiment include dithioerythritol (DTE), dithiothreitol (DTT), xcex2-mercaptoethanol (xcex2ME), tris-(carboxyethyl)phosphine hydrochloride (TCEP), or thioacetic acid, or any derivatives thereof, and the like.
In yet another embodiment for assessing the amount of homocysteine and/or cystathionine present in a solution, the solution can be pretreated with cystathionine xcex3-lyase (CGL), or a derivative thereof, for a time period sufficient to remove any cystathionine from the reaction mixture by the conversion of cystathionine to xcex1-ketoglutarate. Following cystathionine removal the cystathionine xcex3-lyase is removed from the reaction mixture or destroyed. In a typical embodiment, the cystathionine xcex3-lyase is destroyed by heating the solution for a time period sufficient to remove substantially its enzymatic activity. The cystathionine xcex3-lyase can also be immobilized on an insoluble substrate or surface, such as, for example, a micro particle or bead, which can be easily removed.
In still another embodiment of the present invention a method is provided for assessing the amount of homocysteine and/or cystathionine present in a solution comprising the reaction of the solution with L-serine and CBS, or a derivative thereof, and CBL, or a derivative thereof, which have been immobilized on a solid surface. The solid surface can be, for example, paper, filter paper, nylon, glass, ceramic, silica, alumina, diatomaceous earth, cellulose, polymethacrylate, polypropylene, polystyrene, polyethylene, polyvinylchloride, and derivatives thereof. The solid surface can be the sides and bottom of the test container or can be a material added to the test container. In a preferred embodiment the solid surface comprises a bead which is added to the test container.
The CBS, or derivative thereof, CBL, or derivative thereof, and cystathionine xcex3-lyase, or derivative thereof, useful in the present invention can be obtained as a crude extract from a cell. In one embodiment of the present invention the cystathionine xcex2-synthase (CBS), or derivative thereof, cystathionine xcex2-lyase CBL, and/or cystathionine xcex3-lyase (CGL) are purified from human, yeast or bacterial cells. In a particularly preferred embodiment of the present invention the genes which encode the enzymes are isolated or synthesized and are expressed as a recombinant protein in a host cell. It is particularly preferred that a DNA sequence which encodes an affinity tag be added to the gene construct to aid in the purification and/or detection of the recombinantly produced enzymes. Recombinant methods can also be used to provide fusion proteins which comprise the enzyme activities of CBS and CBL in a single protein. An affinity tag can also be included as part of the fusion protein construct to aid in the purification of the fusion protein.
The present invention also provides as a method for assessing the amount of homocysteine in a sample an assay format which correlates the amount of homocysteine/transcription factor complex which is bound to a consensus polynucleotide binding sequence. In a particular embodiment the method comprises contacting the sample with a reducing agent for a time period sufficient to release homocysteine from any associated protein; contacting the reduced homocysteine with a homocysteine metabolite binding transcription factor under conditions conducive for complex formation, admixing the sample with a consensus polynucleotide sequence specifically recognized by the homocysteine/transcription factor complex; and assessing from the amount of homocysteine/transcription factor complex bound to the consensus polynucleotide sequence the amount of homocysteine present in the sample. Reducing agents which are applicable for use in the method comprise borohydride salt or thiol reducing agents including dithioerythritol (DTE), dithiothreitol (DTT), xcex2-mercaptoethanol, tris-(carboxyethyl)phosphine (TCEP), or thioacetic acid, or any salt of each. Homocysteine metabolite binding transcription factors include MetR of E. coli which recognizes a consensus polynucleotide sequence, for example, the polynucleotide sequence as depicted in SEQ ID NO: 11 (Marconi et al., Biochem. Biophys. Res. Commun., 175:1057-1063 (1991)).
Yet another embodiment of the present invention provides a test kit comprising a container for holding the solution to be assessed for the amount of homocysteine and/or cystathionine, L-serine, CBS, or a derivative thereof, CBL, or a derivative thereof, and any buffers, auxiliary substances and solvents required to provide conditions conducive to high enzyme activity. The test kit can further comprise lactate dehydrogenase, or a derivative thereof, and NADH, or a derivative thereof. NADH can be measured directly at 340 nm or, a dye capable of providing a color change when oxidized can be included. The quantity of homocysteine and/or cystathionine is correlated with the change in absorbance measure over time.
In a preferred embodiment the enzymes are provided immobilized to a solid support. The solid support can comprise the surface of the container provided to hold the test sample or can be a bead or other article added to the container. In an additional embodiment of the present invention, cystathionine xcex3-lyase can be provided as part of the test kit to remove any cystathionine from the test solution prior to the enzymatic cycling assay. Substantially all of the activity of the cystathionine xcex3-lyase, or derivative thereof, must be removed from or destroyed in the reaction mixture prior to the addition of the remaining components for the enzymatic cycling of homocysteine.
It has been found that the preferred assay of the invention can be carried out in a relatively short period of time and with relatively small amounts of enzyme, giving an assay which has substantial commercial advantages. For example, the preferred assay involves creation of a reaction mixture including a homocysteine-containing sample, serine, CBS, CBL, lactate dehydrogenase, NADH and a reductant such as DTE or DTT, with the CBS/CBL ratio in the mixture being from about 1:1 to 25:1, more preferably from about 1:10, and most preferably from about 2:1 to 5:1. Advantageously, it has been found that the reductant can be present along with the detection system (i.e., the lactate dehydrogenase and NADH) without deleteriously affecting the assay. Accordingly, the assay of the invention can be carried out without a separate reduction step so that total assay times are reduced. Thus, where a plurality of samples are to be assayed by sequentially creating a reaction mixture in a container (e.g., a spectrophotometric cuvette) made up of a sample, serine, CBS, CBL, lactate dehydrogenase, NADH and the reductant, and assessing the amount of pyruvate present in the reaction mixture by monitoring the production of NAD+ over time, the time interval between the respective reaction-creation steps may be as short as 10-50 seconds with the total reaction time being up to about 20 minutes for a given sample. More preferably, the total reaction time for a given sample is up to about 15 minutes, and still more preferably up to about 13 minutes. The total number of samples assayed per hour may be about 15-30 for slower instruments, but as high as 200-400 for faster instruments. In this preferred assay, a first reaction mixture comprising the sample, serine, lactate dehydrogenase, NADH and the reductant is prepared, with a suitable incubation period to permit liberation of a preponderance (and preferably essentially all) of the homocysteine (total homocysteine) present in the bound, oxidized and/or free states in the sample. Thereafter, CBS and CBL are added to complete the reaction mixture and initiate enzymatic cycling of homocysteine and/or cystathionine.
In another preferred embodiment, cystathionine can be used to make a calibrator(s) for the enzyme assay (since the enzymatic cycling assay interconverts homocysteine and cystathionine). In other words, varying known levels of cystathionine can be used in the assay system to xe2x80x9ccalibratexe2x80x9d or xe2x80x9cstandardizexe2x80x9d the assay and/or instrument which allows for quantitation of sample results. In this embodiment, a known concentration of cystathionine is added to a biological sample and then subjected to the assay used for one of the other embodiments. The results will be used to establish a calibration line which will then be used to set the homocysteine line, due to the high degree of correlation between the two lines. Alternatively, known levels of cystathionine can be used as a quality control measure, to insure that the assay is working properly. In this quality control embodiment, these xe2x80x9cknownxe2x80x9d levels of cystathionine are assayed as if they were unknown samples, and the results are compared to their known (expected) values, in order to insure that the assay system is functioning properly.
The preferred assays are carried out using isolated (purified) CBL and CBS enzymes having at least about 80% (and preferably at least about 90%) sequence identity with the enzymes selected from the group consisting of SEQ ID Nos. 19 and 20. As used herein, xe2x80x9csequence identityxe2x80x9d as it is known in the art refers to a relationship between two or more protein or polypeptide sequences or two or more polynucleotide sequences, namely a reference sequence and a given sequence to be compared with the reference sequence. Sequence identity is determined by comparing the given sequence to the reference sequence after the sequences have been optimally aligned to produce the highest degree of sequence similarity, as determined by the match between strings of such sequences. Upon such alignment, sequence identity is ascertained on a position-by-position basis, e.g., the sequences are xe2x80x9cidenticalxe2x80x9d at a particular position if at that position, the nucleotides or amino acid residues are identical. The total number of such position identities is then divided by the total number of nucleotides or residues in the reference sequence to give % sequence identity. Sequence identity can be readily calculated by known methods, including but not limited to, those described in Computational Molecular Biology, Lesk, A. N., ed., Oxford University Press, New York (1988), Biocomputing: Informatics and Genome Projects, Smith, D. W., ed., Academic Press, New York (1993); Computer Analysis of Sequence Data, Part I, Griffin, A. M., and Griffin, H. G., eds., Humana Press, New Jersey (1994); Sequence Analysis in Molecular Biology, von Heinge, G., Academic Press (1987); Sequence Analysis Primer, Gribskov, M. and Devereux, J., eds., M. Stockton Press, New York (1991); and Carillo, H., and Lipman, D., SIAM J. Applied Math., 48: 1073 (1988), the teachings of which are incorporated herein by reference. Preferred methods to determine the sequence identity are designed to give the largest match between the sequences tested. Methods to determine sequence identity are codified in publicly available computer programs which determine sequence identity between given sequences. Examples of such programs include, but are not limited to, the GCG program package (Devereux, J., et al., Nucleic Acids Research, 12(1):387 (1984)), BLASTP, BLASTN and FASTA (Altschul, S. F. et al., J. Molec. Biol., 215:403-410 (1990). The BLASTX program is publicly available from NCBI and other sources (BLAST Manual, Altschul, S. et al., NCVI NLM NIH Bethesda, Md. 20894, Altschul, S. F. et al., J. Molec. Biol., 215:403-410 (1990), the teachings of which are incorporated herein by reference). These programs optimally align sequences using default gap weights in order to produce the highest level of sequence identity between the given and reference sequences. As an illustration, by a polynucleotide having a nucleotide sequence having at least, for example, 95% xe2x80x9csequence identityxe2x80x9d to a reference nucleotide sequence, it is intended that the nucleotide sequence of the given polynucleotide is identical to the reference sequence except that the given polynucleotide sequence may include up to 5 point mutations per each 100 nucleotides of the reference nucleotide sequence. In other words, in a polynucleotide having a nucleotide sequence having at least 95% identity relative to the reference nucleotide sequence, up to 5% of the nucleotides in the reference sequence may be deleted or substituted with another nucleotide, or a number of nucleotides up to 5% of the total nucleotides in the reference sequence may be inserted into the reference sequence. These mutations of the reference sequence may occur at the 5xe2x80x2 or 3xe2x80x2 terminal positions of the reference nucleotide sequence or anywhere between those terminal positions, interspersed either individually among nucleotides in the reference sequence or in one or more contiguous groups within the reference sequence. Analogously, by a polypeptide having a given amino acid sequence having at least, for example, 95% sequence identity to a reference amino acid sequence, it is intended that the given amino acid sequence of the polypeptide is identical to the reference sequence except that the given polypeptide sequence may include up to 5 amino acid alterations per each 100 amino acids of the reference amino acid sequence. In other words, to obtain a given polypeptide sequence having at least 95% sequence identity with a reference amino acid sequence, up to 5% of the amino acid residues in the reference sequence may be deleted or substituted with another amino acid, or a number of amino acids up to 5% of the total number of amino acid residues in the reference sequence may be inserted into the reference sequence. These alterations of the reference sequence may occur at the amino or the carboxy terminal positions of the reference amino acid sequence or anywhere between those terminal positions, interspersed either individually among residues in the reference sequence or in the one or more contiguous groups within the reference sequence. Preferably, residue positions which are not identical differ by conservative amino acid substitutions. However, conservative substitutions are not included as a match when determining sequence identity.
Reagents useful in the present invention include CBS, CBL, L-serine, LDH, NADH, DTE, xcex2ME, DTT, TCEP, thioacetic acid, and CGL. Concentrations of CBS enzyme useful in the present invention range from about 0.1 to about 100 KU/l. More preferably, the CBS concentration is from about 0.5 to about 75 KU/l, and still more preferably from about 1 to about 50 KU/l. Most preferably, the concentration of CBS is from about 1 to about 30 KU/l. Concentrations of CBL enzyme useful in the present invention range from about 0.01 to about 100 KU/l. More preferably, CBS concentration is from about 0.05 to about 50 KU/l, and still more preferably, from about 0.1 to about 30 KU/l. Most preferably, the CBS concentration is from about 0.1 to about 15 KU/l. L-serine may be present at a final concentration of from about 1 xcexcM to about 50 mM. More preferably, the L-serine is added at a final concentration of from about 10 xcexcM to about 40 mM, and still more preferably at a final concentration of from about 100 xcexcM to about 20 mM. Most preferably, the final concentration of L-serine added is from about 0.2 mM to about 10 mM. When used in any embodiment, LDH is present in the reaction mixture at a final concentration of from about 30 to about 5000 U/L. More preferably, the final concentration of the LDH present in the reaction mixture is from about 30 to about 3000 U/L, and still more preferably from about 50 to about 2500 U/L. Most preferably, LDH is present in the reaction mixture at a final concentration of from about 100 to about 2000 U/L. Additionally, when NADH is used in any embodiment, the amount of NADH present in the reaction mixture can vary between about 0.1 mM to about 2 mM. More preferably, NADH is present in the reaction mixture at a final concentration of from about 0.1 mM to about 1.5 mM, and still more preferably between about 0.1 to about 1 mM. Most preferably, NADH is present in the reaction mixture at a final concentration of from about 0.2 to about 0.8 mM. When DTE is used in the present invention, it can range in final concentration from about 0.01 mM to about 100 mM. More preferably, concentrations of DTE will range from about 0.01 mM to about 50 mM, and still more preferably from about 0.1 mM to about 25 mM. Most preferably, final concentrations of DTE will range from about 0.1 mM to about 10 mM. Similarly, when DTT is used in the present invention, it can range in final concentration from about 0.01 mM to about 100 mM. More preferably, concentrations of DTT will range from about 0.01 mM to about 50 mM, and still more preferably from about 0.1 mM to about 25 mM. Most preferably, final concentrations of DTT will range from about 0.1 mM to about 10 mM. Finally, when CGL is used in the present invention, it can range in final concentration from about 0.1 KU/l to about 100 KU/l. More preferably, CGL will range from about 0.5 KU/l to about 75 KU/l, and still more preferably from about 1 KU/l to about 50 KU/l. Most preferably, final concentrations of CGL will range from about 1 KU/l to about 30 KU/l.